Congratulations on your appointment to the District of Connecticut. Below are the necessary forms we need to process your new appointment. Please begin by reading the Welcome Letter as it contains useful information that will assist you in completing the forms.
Be sure to complete all documents located in Section's A & B
of this web page and bring them to your scheduled HR orientation.
Please also review Section's C & D (specifically for FEGLI & TSP information which have automatic enrollments with premium deductions unless waived prior to EOD).
Please email hr_department@ctd.uscourts.gov if you have questions about completing the forms. Please do not email these forms to us. You will need to bring the completed forms with you to your scheduled orientation meeting in New Haven, CT.
Please be aware that all new appointments are subject to passing an FBI background check and fingerprinting process.
Section A - Bring These Completed Forms With You To Your Scheduled New Appointment Orientation:
AO-78 Application for Judiciary Branch Federal Employment (complete only if not previously submitted)
AO-78B Voluntary Race/Ethnicity, Gender and Disability Identification (complete only if not previously submitted)
AO-197 Law Clerk Promotion Eligibility Checklist (ONLY for Law Clerks)
Emergency Contact Information Form
Form W-4
I-9 Form/Employment Eligibility Verification (NOTE: see the top of page 4 for specific forms of valid ID accepted)
PIVI/FAC Access Badge Information
Acceptable ID for PIVI/FAC Access Badge
SF-1152 Designation of Beneficiary - Unpaid Compensation of Deceased Civilian Employees
SF-1199 Direct Deposit Sign-up Form (leave Section C blank)
SF-2809 Health Benefits Election Form
SF-2817 Federal Employees Group Life Insurance Form (automatically enrolled with premium deductions for basic coverage unless waived)
SF-2823 Designation of Beneficiary - Federal Employees Group Life Insurance
SF-3102 Federal Employees Retirement System Beneficiary Form (for Clerk's Office & Career Law Clerk's ONLY)
State Tax form if you reside outside of CT
VPN Agreement (for Clerk’s Office Staff only)
VPN Agreement (ONLY for Law Clerks)
Section B - Certification Pages Only for the Following Policies:
District of Connecticut Employment Dispute Resolution Plan
Judicial Conference Regulations (please complete, will receive brochure at orientation)
Model Confidentiality Statement
Section C - Supplemental Information for Choosing Optional Benefits:
Benefits for New and Prospective Employees
Benefit Plan Information and Summaries for Connecticut (and all states)
FEHB (Federal Employees Health Benefit) Premium/cost information
Federal Employees Group Life Insurance (FEGLI) Booklet (automatically enrolled for basic with premiums withheld unless waived)
Flexible Benefit Program Brochure (Medical & Dependent Care Reimbursement)
Flexible Spending Account – How to Enroll
Thrift Savings Plan (TSP) (Term Law Clerk's are not eligible to participate; all others are enrolled at 3% of pay with premiums withheld per pay check unless waived)
Vision and Dental Plans (must enroll within 60 days of hire)
Dental and Vision Insurance Rates
Section D - Other Resources:
Federal Court Clerk's Association (FCCA) & Membership Information (Optional)
Holidays & Bi-Weekly Pay Calendar
Law Clerk: Interactive Orientation for Federal Law Clerks (iOLC)
Law Clerk Qualification Standard
Leave Administration & Accruals
Annual Leave Accrual (where applicable if covered under the Leave Act)
Sick Leave Accrual (where applicable if covered under the Leave Act)
The United States Courts Library for the Second Circuit